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General NPI Number Information
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NPI Number | 1164078713
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Entity Type | Individual
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Provider Name | LORI DIAS
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Gender | Female
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 76 SUMMER ST
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City | HAVERHILL
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State | MA
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Zip | 01830-5814
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Country | US
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Telephone | 978-373-8222
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Fax | 978-373-8223
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Provider Business Mailing Address
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Address Line | 333 BORTHWICK AVE
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2284228
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2284228
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License Number State | MA
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